Evidence has accrued that several drugs may prolong cardiac repolarisation (hence, “measured as” the QT interval of the surface electrocardiogram) to such a degree that potentially life-threatening ventricular arrhythmias e.g. torsades de pointes (TdP) may occur, especially in case of overdosage or pharmacokinetic interaction.
The number of drugs reported to induce QT interval prolongation with or without TdP continues to increase (W. Haverkamp et al. (2000) Cardiovascular Research 47, 219-233). As many as 50 clinically available or still investigational non-cardiovascular drugs and cardiovascular non-anti-arrhythmic drugs have been implicated. A number of drugs, both old and new, have either been withdrawn from the market or have had their sale restricted. Of concern is the interval, usually measured in years, from the marketing of these drugs to initial recognition of their association with QT interval prolongation and/or TdP. It would therefore be beneficial to investigate any new chemical entity for this potential side effect before its first use in man at an early stage of the development of new therapeutics and/or other agents.
A key component in the present development of new therapeutic agents consists of High Throughput Screening (HTS) of chemical compound libraries. Pharmaceutical companies have established large collections of structurally distinct compounds, which act as the starting point for drug target lead identification programs. A typical corporate compound collection now comprises between 100,000 and 1,000,000 discrete chemical entities. While a few years ago a throughput of a few thousand compounds a day and per assay was considered to be sufficient, pharmaceutical companies nowadays aim at ultra high throughput screening techniques with several hundreds of thousands of compounds tested per week. In a typical HTS related screen format, assays are performed in multi-well microplates, such as 96, 384 or 1536 well plates. The use of these plates facilitates automation such as the use of automated reagent dispensers and robotic pipetting instrumentation. Further, to reduce the cycle time, the costs and the resources for biochemicals such as recombinant proteins, HTS related screens are preferably performed at room temperature with a single measurement for each of the compounds tested in the assay.
A decisive criterion in the lead evaluation process will be an early recognition of their potential association with QT prolongation and/or TdP. However, there are currently no reliable, fast, easy screening methods available to assess cardiotoxicity, which can cope with the number of compounds identified in the currently deployed HTS techniques. It is an object of this invention to solve this problem in the art by providing assays and kits which are based on the finding that the interaction of astemizole with the HERG potassium channel can be exploited to predict cardiotoxicity of compounds during the development of new therapeutics and other agents.
The currently available in vitro models comprise heterologous expression systems, disaggregated cells, isolated tissues and the isolated intact (Langendorf-perfused) heart. In all models the effect of potassium current blockade is assessed by measurement of either ionic currents using two-electrode voltage clamp recordings (Dascal N. (1987) Crit. Rev. Biochem 22, 341-356) or patch-clamp recordings (Zhou Z. et al., (1998) Biophysical Journal 74, 230-241), of membrane potentials using microelectrodes or confocal microscopy (Dall'Asta V. et al. (1997) Exp. Cell Research 231, 260-268). None of the aforementioned methods can be used in an HTS screen in view of the complexity of the experimental procedures, the slow cycling times, the nature of the source materials (i.e. isolated tissues and disaggregated cells thereof) and the reliability of the test results.
The present inventors surprisingly found that a binding assay using labeled astemizole as a specific ligand for the HERG channel can be used to predict the potential association of compounds with QT prolongation and/or TdP. This binding assay solves the aforementioned problems and can be deployed in an HTS related screen format.
A similar assay has been described by Chadwick C. et al. (Chadwick C. et al., (1993) Circulation Research 72, 707-714) wherein [3H]-dofetilide has been identified as a specific radioligand for the cardiac delayed rectifier K+-channel. This article further demonstrates a good correlation between dofetilide displacement and potassium channel blocking activity of a number of antiarrhytmic compounds. This binding assay facilitates the characterization of drug-channel interactions at the molecular level.
In this assay labeled dofetilide has been prepared from the dibromo precursor by 3H-exchange yielding the incorporation of two 3H-labels per molecule. There is a direct correlation between the number of 3H-labels per molecule and the sensitivity of the binding assay. The present invention provides an improved binding assay over the above, as the use of a desmethylastemizole precursor in a reaction with [33H]-methyliodide resulted in the incorporation of three 3H-labels per molecule astemizole. The specific activity of the thus obtained radioligand is 1.5-2 times higher than the specific activity of [3H]-dofetilide.
Further, the dofetilide assay could not be used in an HTS related screen format since the ventricular myocytes isolated from adult male guinea pigs had to be used within 6 hours of isolation. In addition only 36% of the isolated cells were viable and could be used in the binding assay. In order to be used in an HTS related screen, the starting material should be readily available and in sufficient amounts. The present invention solves this problem as membrane preparations of HEK293 cells, stably expressing the HERG potassium channel, are used. Said cells can be maintained in culture in sufficient amount avoiding the need and supply of animal models and as cell membranes are used in the binding assay, the latter can be stored in binding assay ready aliquots at −80° C. for later use. A further drawback of the dofetilide binding assay described by Chadwick et al. has to do with the incubation protocol. As viable myocytes are used, the incubation has to be performed at the physiological temperature of 34° C. The latter undoubtedly increases the costs, possible cycle time and complexity of the assay if to be performed in an HTS related screen format. The present invention solves this problem as it was surprisingly demonstrated that the membrane preparations could be incubated at room temperature. Espescially in light of a study by Zhoe Z. et al. Zhou Z. et al., (1998) Biophysical Journal 74, 230-241) which concluded that the kinetic properties measured for HERG are markedly dependent on temperature and that differences observed in several reports, are diminished when studies are performed at physiological temperatures, i.e. 35° C.
This and other aspects of the invention will be described herein below.